Pontine haemorrhage is most often associated with hypertension and arteriovenous malformations.

large central pontine lesions are often fatal. They may dissect into the tegmentum and the fourth ventricle, and rostrally, into the midbrain. Quadriplegia, coma, small reactive pupils and bilateral paralysis of horizontal conjugate gaze are typical sequelae. Spontaneous downward eye movements - ocular bobbing - imply preservation of rostral brainstem gaze centres.

smaller unilateral basal pontine lesions show contralateral hemiparesis, often with ataxia in the limbs affected.

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